1489 Wellington Way - Inspection Form' Eity of hp
Residential Sanitary Sewer Service
Compliance Inspection
House Number )
Alternative Mailing Address
f
( :I
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
t
0 No sump pump
Service Lateral Inspection Findings
Roots
Poor PipeJoints
Mineral Deposits
4" to 6" Transition:
White Copy: Property Owner
Time
Date
Name f "�1t i i� Disk#
PID Number
Owner/Occupant Signature
am
pm
Street Name
For information call 651.470.2788
Non - Compliance
O Clear water. connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
SaglPipe Deflection
Damaged Pipe
Transition - 1 i 3 ��‘ � � r .� /] ,',
Phone !:
Number of stacks Entered SL at ..
Yellow Copy: City of Eagan
Record Number
r am
IA, Time • o' pm
inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
f ' „ !/
Length of Service: l * Final Cleanout:., ? '”
' `
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
_ 1 1'(,, .3 LAI ; ' (-2 =?'---
] ?— 'f
J d C.
i
X1 4
�. �^ 3
X 1 r' f- .. `. .
f -
Total
Sump pumps
4
Foundation drains
i ns
Roof drains
' Eity of hp
Residential Sanitary Sewer Service
Compliance Inspection
House Number )
Alternative Mailing Address
f
( :I
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
t
0 No sump pump
Service Lateral Inspection Findings
Roots
Poor PipeJoints
Mineral Deposits
4" to 6" Transition:
White Copy: Property Owner
Time
Date
Name f "�1t i i� Disk#
PID Number
Owner/Occupant Signature
am
pm
Street Name
For information call 651.470.2788
Non - Compliance
O Clear water. connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
SaglPipe Deflection
Damaged Pipe
Transition - 1 i 3 ��‘ � � r .� /] ,',
Phone !:
Number of stacks Entered SL at ..
Yellow Copy: City of Eagan
Record Number
r am
IA, Time • o' pm
inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
f ' „ !/
Length of Service: l * Final Cleanout:., ? '”
' `
Pink Copy: SEH